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Dealing with Menopause

Fall/Winter 2000

A note from TheBody.com: Since this article was written, the HIV pandemic has changed, as has our understanding of HIV/AIDS and its treatment. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!

Information compiled from Planned Parenthood and the WIHS, provided by our Promotora, Brenda Calderon

For many reasons some women think menopause will bring negativity into their lives. I think and believe that if we as women inform ourselves about menopause, a stage that our body will go through, and prepare our minds with the tools to deal with this part of life, I think menopause will have a different result after all. That's the reason why I thought that by writing about it, I would prepare us for it somewhat. Some women are probably going through these stages. Here is some information that I got from a very good pamphlet from Planned Parenthood titled: FACTS for Life.


What Menopause Means

Menopause is the time at "mid-life" when a woman has her last period. It happens when the ovaries stop releasing eggs. Most often it is a gradual change. Sometimes it happens all at once.

Perimenopause is the gradual period of change leading into menopause.

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It affects women's hormones, body, and feelings. It can be a rocky, stop-start process that takes years. "Climacteric" is another word for the time when a woman passes from the reproductive to non-reproductive years of her life. The ovaries production of estrogen slows down during perimenopause. Hormone levels fluctuate, causing changes just as they did during adolescence. But for many women, the changes leading to menopause are much more intense than those of puberty.

The time after menopause is called postmenopause.

Temporary "stress menopause" occurs when women in their late 30s or older have no periods for long stretches of time. It can be caused by stress, chemotherapy, grief, illness, bulimia, anemia, or excessive exercise.

Surgical menopause occurs if the ovaries are removed or damaged as in a radical hysterectomy or chemotherapy. In this case, menopause begins immediately, with no perimenopause.


Signs of Menopause

As most women approach menopause, their menstrual periods become irregular, they happen closer together and/or further apart.

Other common signs include:

  • achy joints;

  • night sweats;

  • difficulty in concentrating;

  • changes in sexual desire;

  • headaches;

  • extreme sweating;

  • hot flashes;

  • frequent urination;

  • insomnia;

  • vaginal dryness; and

  • mood changes -- conditions commonly associated with PMS.

Women may have one, some, or none of these signs. But the ones she does have can be so unpredictable and disturbing that she can feel like she's "going crazy."

A women's experiences during menopause may also be influenced by other life changes such as:

  • Anxiety about loss of independence, disability, or loneliness.

  • Increasing numbers of perimenopausal women also have young children to care for.

Whatever the cause or circumstance, the conditions women experience before and after menopause are very real and sometimes very serious, especially if it's a woman living with HIV. Take in consideration that about 10-15% become physically or emotionally disabled for various periods of time by the menopause condition.


Menopause Is Unpredictable

Perimenopause may begin as early as 35. It starts about two years earlier for women who smoke than for women who don't. The timing is not related to race, class, pregnancy, breast-feeding, fertility patterns, birth control pills, height, age of menarche (first period), or age at last pregnancy.

The average age for menopause is 51. If menopause is reached naturally or surgically before the age of 40, it is called early menopause.

Estrogen levels drop very abruptly during surgical menopause, especially when both ovaries are removed at the same time. This often intensifies the conditions associated with menopause and may lead to major physical and emotional changes, including depression.

It is somewhat reassuring to remember that perimenopause is just a phase, that all these symptoms are temporary. For most women it will last two or three years, though for some it lasts as long as 10 or 12 years.

It is important to remember that all women need regular checkups, whether or not they are menstruating.


Hot Flashes and Night Sweats

Hot flashes are sudden explosions or mild waves of upper body heat that last from 30 seconds to 5 minutes.

They are caused by sudden changes in hormonal levels in the blood. Hot flashes often start with a tingling sensation in the fingers. The tingling is followed by fast rises in skin temperature from the chest to the face and rapid heart palpitations. 75% of women have hot flashes during perimenopause. 50% of women have one each day. 20% have more than one a day. 10% have them up to five years after menopause. They are very uncommon after that.

Hot flashes often include drenching sweats that can soak the bedding when they happen at night.


Some Tips for Relieving Hot Flashes

Try regular exercise, biofeedback, cold showers, decreased stress, and cooler rooms. Reduce intake of tea, alcohol, hot beverages, and spicy foods. Wear thin layers of all-cotton clothes that can be removed. Don't wear nightclothes with collars because they are warmer to sleep in. Keep extra nightclothes next to the bed in case you need to change during the night.

Keep a hot-flash diary to learn what triggers them. Sometimes hot flashes can occur at night. (You may want to keep a hand towel by your pillow to wipe the perspiration from your neck.)

Women who have hot flashes generally weigh less than women who don't.


Traditional and Alternative Therapies

There are many therapies for the conditions associated with menopause. Hormone replacement therapy (HRT) works for millions of women. But the hormones used in HRT may pose risks as well as benefits.

Many women avoid those risks by choosing alternatives, including: homeopathy, Chinese medicine and/or herbal treatments.

Alternative therapies may also have undesirable effects. It is best to consult a skilled, experienced practitioner to determine the remedy, dose, and treatment schedule for whatever therapy is chosen.

  • Non Hormonal Treatment: Over-the-counter creams without estrogen are also available.

  • Homeopathy: Homeopaths use minute doses of medicines that in larger doses cause symptoms like those of the condition being treated.

  • Herbal Treatments: Herbalists use herbal extracts, capsules, and infusions, especially those rich in phytosterols, plant estrogens and progesterones.

  • Chinese Medicine: Chinese medicine practitioners use acupuncture and herbal treatments to harmonize a person's life energy or Qi (chee).

Many women also benefit from counseling during mid-life changes.


Hormone Replacement Therapy

Up to 20% of menopausal American women use HRT because they believe the benefits outweigh the risks.

It is believed that prolonged use of estrogen replacement reduces the risk of heart attack by nearly 50%. Women base their decisions on their individual and family medical histories.


Benefits

  • Prevents osteoporosis

  • Eliminates hot flashes

  • Decreases the risk of heart disease

  • Improves energy, mood, and sense of well-being

  • May restore sexual desire

  • May reduce the risk of Alzheimer's disease

  • May reduce the risk of colorectal cancer

  • May improve concentration and memory


Risks

  • May cause symptoms like PMS

  • May cause breast swelling or pain

  • May increase risk for breast cancer

  • May have other undesirable side effects, including: vaginal bleeding, fluid retention, nausea, loss of hair, headaches, itching, increased cervical mucus, and corneal changes that prevent the use of contact lenses


Be Prepared

Ensure continued good health for yourself with annual Pap tests, or every six months for a HIV+ women, pelvic and breast exams, and mammograms can help prevent cervical and breast cancer. A good low-fat, high-calcium diet and plenty of weight-bearing exercise three or more times a week may help prevent osteoporosis and heart disease. Use condoms to protect against sexually transmitted infections. Start preparing for perimenopause and menopause as early as possible. Today is a good time, no matter how young you are.


After Menopause

Some women discover a sense of liberation, they are eager to say good-buy to premenstrual syndrome. Many others face increase responsibilities and declining health. But on the whole, postmenopausal women are the least likely of all women to be depressed. They have a greater sense of well-being than at any other point in their lives.

I hope this information comes in handy to all the women that will read this article, because menopause is not a subject we talk about too often, I think can help us understand better our normal body changes in life.

Ask your doctor about all the concerns that you may have regarding any symptoms that you identified in this article, your doctor may do some tests and clarify your concerns.


Watch Out

Sometimes we can get confused by a condition called amenorrhea (absence of periods). Women Alive published an article in the Fall 1996 issue regarding "Menstrual Irregularities." It got my attention because many women may be suffering with this condition and may be confusing it with menopause. The following information came from the WIHS Study (Women's Interagency HIV Study), by Dr. Mardge Cohen.

"Women with HIV have noted many complaints about abnormal menses (periods). This study examined menstrual abnormalities in a large group of HIV infected women and uninfected control group. The purpose was to compare the prevalence and origin of amenorrhea in women with and without HIV, and to describe menstrual abnormalities in HIV positive women. Data for this analysis was available for 2,214 women. We concluded that women with HIV are nearly three times more likely to get amenorrhea after adjusting for important variables. Amenorrhea was more frequent in women with lower CD4 counts and albumin levels of less than 3. Current heroin and amphetamine use were significantly associated with amenorrhea in women with and without HIV infection. The cause of amenorrhea was most often due to abnormal pituitary function in women with HIV infection."

I hope this information helps you all to understand Menopause and if you have any question please call us at Women Alive (323) 965-1564.

Source: "Menopause, Another Change in Life." Revised version March 1998, Written by: Jon Knowles.


A note from TheBody.com: Since this article was written, the HIV pandemic has changed, as has our understanding of HIV/AIDS and its treatment. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!



  
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This article was provided by Women Alive. It is a part of the publication Women Alive Newsletter.
 
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